HIV And Children
HIV And Children
Charles Farthing (Chief of Medicine, AIDS Healthcare Foundation) gives expert video advice on: What are the survival rates for babies who have HIV?; How do children contract HIV?; What can I do to protect my child against HIV? and more...
How will a baby be tested for HIV?
Babies born to HIV-positive mothers automatically have an HIV antibody test that's positive for about the first year to 18 months, because the antibody molecules from the mother transmit into the blood. It doesn't necessarily mean that the child is infected with HIV. The only way to know if an infant is infected is to actually do a DNA PCR or an RNA PCR, but preferably a DNA PCR test which looks for the virus itself. That should be done about six weeks to three months after the child is born.
Why are babies given DNA PCR tests?
DNA PCR is looking for the viral DNA, the viral genetic material in the form that it's in, when it's infecting cells. So when you're using an HIV DNA PCR, you're looking for lymphocytes that are infected with HIV, genetic material, in the baby. You don't want to wait until 18 months when the antibodies would have left the blood if the child is not infected, and only be present if the child is infected, because half of the HIV positive babies will die in the first year, so you really want to diagnose it well before.
When will a baby who is infected by HIV begin to show symptoms?
Children infected with HIV may begin to show symptoms very early, within the first few months. In fact, if the baby was infected during pregnancy and not during the birth process, the baby may be sick, malnourished, and underweight at birth.
What are the survival rates for babies who have HIV?
Survival rates for babies who have HIV are very good if they get appropriate therapy. Unfortunately, access to HIV therapy for infants although excellent in the United States are very poor in many parts of the world, poorer than access to HIV treatment for adults. Parents are nervous about bringing children to the doctor for HIV treatment, because children talk and you can't keep your HIV diagnosis a secret. So, it is a big problem worldwide to get HIV-positive babies treated. In the United States, it is not difficult but it is almost not necessary because we have hardly any HIV-positive babies because we prevent mother-to-child transmission.
How do children contract HIV?
Children seldom transmit or contract HIV until they become sexually active. But children can become sexually active at a young age, and people should be very aware of that and commence sex education and safe sex education very early, to prevent HIV transmission. I think parents are often surprised at how soon sexual activity begins.
Can my child contract HIV by coming into contact with an infected child on the playground?
It's very unlikely that one child could infect another child with HIV on the playground. There's no exchange of bodily fluids. There's no intravenous drug use. So playground HIV infection doesn't happen.
What infections are HIV positive children susceptible to?
In children with HIV, the illness is very similar to that with adults but there are a few important differences. There are some conditions that are seen in children with HIV like lymphocytic interstitial pneumonitis, a pulmonary lung condition that is not seen much in adults. There are developmental abnormalities in children with HIV that paediatricians are used to watching. A sick child, especially one with HIV, doesn't grow as well. A sick child, especially one with HIV, doesn't develop as well. They are the things that paediatric doctors notice in children with HIV. There is some expertise needed to look after children with HIV but again, the disease is very similar.
What treatments are available for children with HIV?
Pretty much the same treatments that are available for adults are available for children with HIV. Unfortunately, for some of the newest HIV drugs, when they come out, the clinical trials have not been done in children to determine the right doses. So sometimes it's harder to get some of the newer HIV treatments for children, because the development of paediatric dosage formulations lags behind. But generally speaking, creative physicians can provide HIV positive children with almost everything that you can provide adults with.
Are adolescents and teenagers at a higher risk for HIV than adults?
Adolescents and teenagers can be at high risk of HIV because they're much less likely to practice safe sex, because they're much less likely to even know about it. And this varies greatly from country to country. In Scandinavian countries, where safe-sex education begins in the school and is very thorough, there's very little teen pregnancy and there's very little transmission of sexually transmitted diseases, including HIV. In the United States, where there's really no significant sexual education in the schools and safe-sex education, we have one of the highest pregnancy rates in the developed world, and we have sexual transmission and we have HIV transmission. And that's very sad. We should definitely improve our safe-sex education to children and to teenagers in this country.
What can I do to protect my child against HIV?
To protect your child against HIV, educate your child. Tell him how HIV is transmitted. Tell him or her about sex, and how to protect themselves and how to practice safe sex.